The Over-Trained Athlete & What to Do About It

Everyone has an athlete in them.  Even at 90.  Everyone can also be an over-trained athlete, regardless of the frequency of your actual exercise or training.  Hit a plateau, just feel low or fatigued, or lack motivation in general?  Chances are you are in an over-trained state.

Patient “Hey Doc, I have been experiencing some medial (inside) knee pain during my weight training workouts that persists and does not go away until a few hours after, while I am resting at night. I want to be able to start running or doing more cardio post lifting workouts, but am afraid it will make my knee worse.”

PT “How often are you doing weight training? And are you doing any cardio before or after your weight training?”

Patient “6 days a week but am really taking it easy. I do some cardio in the form of metabolic conditioning in the workout and sometimes jump on the rower for some long slow distance for 10 minutes after the workout. I do not feel like I am making any gains or really progressing at all which sucks.”

PT “What movements bothers your knee when you are weight training or doing cardio?”

Patient “Mostly doing fast squatting like when I Snatch, or Clean, or attempt pistols. It hurt even unloaded when I did Murph on Memorial Day…. like 10 of the 300 squats in. Weirdly enough, when I kneel and give my kid a bath it also bugs me AND sometimes when I have to go #2…it bugs me.”

PT “Do you ever feel fatigued outside of training, low motivation, feel like your heart rate is elevated, do you rely on coffee to keep you awake during the day, does the pain seem to be more diffuse then when it first started, sleep less than 8 hours a night, feel like you have been at a plateau with your training for more than 3 months?”

Patient “Uhhh, yeah to all of the above!”

PT “Ok. First I want to look at your movement patterns especially the ones you use in your workouts, then let’s take a look at how you can improve your fitness by improving your recovery. I want to look into the quality of your sleep, what you eat, and how you process stress. Your body and mind may be in an over trained state. To break out of that you must learn to move within your bodies capacity and recovery better. Let’s get started.”

Does this sound like your story? Are you a mom, dad, CrossFit athlete, runner, etc. who has pain or fatigue issues? Whether it is the knee, low back, shoulder, or any other body part that hurts, one must consider a very important component to what makes up a fit, healthy body and mind: proper recovery!

Over-trained or Not: What is Recovery?

Recovery is your ability to enter a rest and digest state – aka parasympathetic state – during your day and night. It is physiologically and psychologically crucial to our ability to live a long time and actually enjoy our life. We all deserve to feel good and if you do not, that is not normal. If you are running from a bear or hunting, a high pressure meeting or in an intense workout, your body will be in freeze or flight mode, which it can handle. In the bear situation it truly depends on your survival skills. In most cases we are built to survive threats unless eaten.

The key to recovery is what happens to your body and mind the other times of the day when you are not just surviving. Here are some key biological feedback systems to monitor to tell if you your body and mind are in rest and digest mode (parasympathetic) vs a freeze or flight mode (sympathetic):

• Your resting heart rate is lower than 70 beats per minute
• Your heart-rate variability (HRV) on a regular basis has some space between beats
• Your respiratory rate is lower than 8 breaths per minute
• You’re getting 7.5 to 8 hours sleep a night
• You are more of a nose breather all day long
• You have rest days as a part of your programming that make sense to your work output
• Your shoulders/neck, low back feel relaxed and healthy
• Your mind feels calm and clear
• You are not in any kind of pain

If the above is not on point and you are training like a maniac but have not reached your goals, feel like you are not getting stronger, are using ice constantly, not able to lose any weight, and/or experience constant aches and pains in your body, then chances are you are in an over-trained state. Don’t worry, it is not a scarlet letter, rather an education in body and mind care. The better you recover the more fit your movement and mindset will be not just training, but in your life.

What Does it Mean to be Over Trained?

“There is an actual syndrome called overtraining syndrome (OTS) which appears to be a maladapted response to excessive exercise without adequate rest, resulting in perturbations of multiple body systems (neurologic, endocrinologic, immunologic) coupled with mood changes.”

To go into a little more details about OTS, there is usually a build up to it over time. A study put out by Dr. Kreher and Dr Schwarz in 2012 showed, “increased loads are tolerated only through interspersed periods of rest and recovery—training periodization. Overreaching is considered an accumulation of training load that leads to performance decrements requiring days to weeks for recovery. Overreaching followed by appropriate rest can ultimately lead to performance increases. However, if overreaching is extreme and combined with an additional stressor, overtraining syndrome (OTS) may result. OTS may be caused by systemic inflammation and subsequent effects on the central nervous system, including depressed mood, central fatigue, and resultant neurohormonal changes.”

Overreaching and over-trained states can go on for days, months, or even years without one knowing it. Unfortunately, what typically happens is one will be in an over-trained state but not understand that they are. They seek medical care and are told to STOP doing what they love, rest, take medication, and consider doing something different. Or they keep going thinking this is a normal feeling and they should just suck it up because everyone has pain and discomfort, right? This creates a downward spiral to being unhealthy for the long run. Your body should feel good. When you recover well, you feel good most days. Our medical culture honesty supports reactive medicine more than proactive. Being proactive is what our long term health is built from. Proactive means taking the advice you receive in this series of articles and applying them to your life now.

So here is our proactive approach:

Understand What to Measure if you Think You Are an Over-Trained Athlete

Whether you feel you are in an over-trained state or not, track your resting heart rate in the morning.

“Measuring your morning heart rate is pretty simple. All you need is a digital watch, a small notebook and a pen on your nightstand. As soon as you wake up in the morning, find your pulse on your neck, just under your chin, or on your wrist. Using the watch, count the number of times your heart beats for 20 seconds. Multiply this number by three and you have your resting heart rate (RHR) in beats per minute (bpm). Record this number in your notebook next to the day’s date. Now make sure to repeat this process every morning. With each passing day, you’re creating an accurate record of your morning heart rate that you can reference after challenging workouts to ensure that you’re recovered. You can also look at this data when you think you might be facing a case of overtraining. Before trying to glean any insight from these numbers, however, be sure to record at least three weeks of data.”

“Keep an eye on your resting morning heart rate in the two or three days after a hard workout. If it’s significantly elevated from its normal average (7 or more additional beats per minute), that’s a sign that you’re not fully recovered from the workout. Remember, there is going to be some variability in your daily heart rate regardless of your recovery level, do don’t be concerned if you’re 3 to 4 bpm over your normal average on a given day. In my experience, it takes a reading that’s 7 bpm higher than normal to signify excessive training fatigue.”

Age, the OTHER 23 hours, Your Warm Up, Cool Down, Movement Patterns, and Length of Time of Training Matter too if You are in an Over-Trained State or Not

A. THE OTHER 23 HOURS IN AN OVERT-RAINED ATHLETE:

You must keep in mind your age, what you do the 23 hours of the day outside the gym, and your goals. If you are 40 years old, work a desk job or are a pilot who sits a lot, this will change your ability to move in a healthy manner. If you expect with this kind of sedentary life that every morning the only warm up you do to prepare for your regular 3-5 mile run or WOD is put on your shoes, and the only cool down is a hot shower, eating your breakfast standing up, then walking to your car to sit and drive to work, you are wrong. We have found this is common, but not healthy behavior.

B. AGE CONCERNS FOR AN OVER-TRAINED ATHLETE:

You should workout and move at any age.  In their World Report on Aging and Health, the World Health Organization (WHO) looked at health across the lifespan. When they looked at intrinsic capacity – basically activity and function – the different levels seen across the lifespan were “largely the result of cumulative impact of behaviors and exposures during a person’s life course.” In general, this doesn’t mean our function declines because we are getting older, it is generally because our lifestyle changes and we become more sedentary as we age.

Another key factor as we age is the even greater importance of recovery time. We’ve all said it – “I just don’t quite bounce back like I used to.” This is your body’s way of telling you that you need more time to recover in between workouts. Research shows that muscles in older adults doesn’t recover as quickly after a workout, so give yourself anywhere from 2-3 days of active rest.

C. WARM UP & COOL DOWN OPTIONS FOR AN OVER-TRAINED ATHLETE:

The next thing to think about is whether are you giving your body a proper warm up and cool down. Meaning before you go run or WOD are you performing movements to warm up the tissue in the positions that you will be doing in the workout. For example, running takes the shape of a lunge, so performing lunges to warm up, or butt kicks followed by some dynamic (not static) mobilizations for your joints will help you recruit the right motor units and open up ranges of motion that you need to move with ease. It also just simply warms your body up for your workout which helps increase body heat which makes your tissues able to adapt more quickly to the upcoming workout. The cool down just as important. After you just build a ton of heat in your body and worked it to the bone, then you need to take care of the beat up tissues that will go back to being stiff really quickly.  Post-exercise, perform some kind of soft tissue mobilization or dynamic stretching like proprioceptive neurofacilitation (PNF). The key is doing it on areas you just used a lot like the glutes, the spine, the hamstrings etc.

D. MOVEMENT PATTERNS & HOW OFTEN FOR AN OVER-TRAINED ATHLETE:

The final piece is how you are moving and how often. If you do not know how to load your body effectively or maintain a good form in your spine or extremities, then your body is dumping work capacity left and right. You may think you are moving well, but if you are experiencing ANY of what we have discussed in this article – pain with movement, lack of sleep, increased resting heart rate, do not warm up or cool down, know that you have range of motion restrictions – then chances are you really need some movement pattern retraining. The movement patterns that are the most efficient are pain free. However, you could have amazing movement patterns, but also be training way too much, not giving your body a chance to recover. If you are a 6 days a week-er doing WODs or running the same path every day or even different paths but running is what you do, then chances are you need some recovery in there because your body cannot sustainably support what your mind wants your body to do.

Get Help:

Did you know asking for help is a sign of strength?  Whether you are a new mom or dad, into CrossFit, running, or any other activity, over-training can happen. Think about it.  Pain and fatigue is seen as common in our society.  BUT IT’S NOT NORMAL. Sleep is not for the weak…it is for the strong. How you cope with work and your life matters.

Don’t you think this has gone on too long and gotten in the way of doing what you love? If you know now that you are in an over-trained state, get some help for it from someone who understands the workouts and movements you love to do, who also understands programming, and is a ninja in teaching proper ways to recover that can apply to your life right now. Getting your movement assessed is important is because you need to know where in your movement pattern your form is breaking down, where you are limited in mobility, and where you lack control of your mobility in the joints you are loading. You go to the dentist to get your teeth checked out right? Well your teeth do not carry you around during your day. Your bodies movement does.

Whether you simply do high intensity functional training, CrossFit, are a mom or dad, are a runner, go to LA fitness or a 24 fitness, train at home, run races on the weekend, are just starting a training program, or all of the above, this applies to YOU.

Movement Rx can help you. We are offering a limited time special combo deal.  Get world class hands-on care along with one of our incredibly effective 8 week online strength & conditioning prehab programs.  Even if you are not local to San Diego, you are in luck because the programs are digital and we do offer virtual one on one physical therapy sessions.

Click HERE to learn more:

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435910/
http://running.competitor.com/2014/06/training/think-youre-overtraining-check-your-pulse_63593
http://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf;jsessionid=6EEE1E4F1ECD6099747C417CF57104B3?sequence=1
https://www.ncbi.nlm.nih.gov/pubmed/20703499
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693453
Woman Picture: https://www.myweightlossfun.com/fitness-articles/how-to-recover-from-overtraininga-lesson-to-learn/
Man Picture: http://breakingmuscle.com/fitness/low-testosterone-you-could-be-overtraining